Is surgery the best treatment for a first-time shoulder dislocation?
This is the question surgeons are hoping to answer in a new research study called “REDUCE” – A Randomized trial Evaluating first-time shoulder Dislocation: sUrgery versus Conservative carE.
The shoulder is one of the body’s largest joints that can also move through the greatest range of motion. Because of this, it is also the joint that is most commonly dislocated.
Most shoulder dislocations occur in an “anterior” direction where the shoulder is forced forwards (anterior dislocation). The humeral head (the ball-shaped end of the humerus) moves forward and out of the glenoid cavity (the “socket”).
Anterior dislocations are often complicated by instability and repeated dislocations. Shoulder instability results in pain and can negatively affect quality of life. Several long-term research studies have also demonstrated a relationship between repeated dislocations and the risk of arthritis.
— Learn more about the basics of shoulder instability —
Management options for a first-time shoulder dislocation include non-operative and operative care, with the most common option being non-surgical / conservative treatment.
Despite this, research over the past 10 years suggests that surgical treatment may be a more reliable way to treat first-time shoulder dislocations – preventing future dislocations and improving patient outcomes. For this reason, there is debate about whether surgical treatment should be routinely performed in patients after a first-time shoulder dislocation. However, no high-quality research studies have compared the two treatments head-to-head, so surgeons do not clearly know which treatment is the best.
This research study will provide surgeons with new information regarding the best treatment for a first-time shoulder dislocation.
The REDUCE Study
This research study will compare surgical treatment (arthroscopic stabilization) and non-surgical treatment (physical rehabilitation).
Who is eligible for this study?
If you are between the ages of 14 and 40 and have had a first-time anterior shoulder dislocation within the last 3 months, you may be a candidate for this study.
What is involved in participating in this research?
If you agree to participate in this research study, you will be asked if you’re willing to be randomized in the study.
Randomization means putting you into a treatment group by chance, like flipping a coin. There is no way to predict which group you will be put into. You will have an equal one-in-two chance (or 50%) of being in the surgical or conservative treatment group. Neither you nor your study doctor can choose what group you will be in.
If you are not comfortable being randomized, you can be part of the non-randomized study group, where you can choose which treatment you want.
You will also be asked to complete:
- Routine tests and procedures for a dislocated shoulder including physical examinations
- Strength testing
- Online questionnaires to track your pain and other symptoms, your ability to perform daily activities and sports, and how your shoulder affects your quality of life and emotions
- Regular clinical visits for 2 years after to measure your progress and ensure you are recovering well
What are the benefits of participating in this study?
If you agree to participate in this study, there may or may not be a direct medical benefit to you. Your condition may be improved during this study because of the treatment to stabilize your shoulder, but this research is not guaranteed to help you.
The information we get from this study may help surgeons learn the best treatment for a first-time shoulder dislocation.
— Learn more about clinical research and why our physicians participate in studies —
